Individual provider Active NPI

Alia Meagan Kabbara, DMD

  • Dentist
  • Corona, CA
National Provider Identifier
1003504598
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108978 Issued in CA
Practice address
3848 N McKinley St
Corona, CA 92879-6569
Phone
(951) 371-2424
NPI assigned
Apr 24, 2023
Last updated
Oct 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 108978 CA Primary

Addresses

Primary practice location

3848 N McKinley St
Corona, CA 92879-6569

Mailing address

18392 Old Lamplighter Cir
Villa Park, CA 92861-4528
Phone (714) 944-3983

Other practice location 1

18392 Old Lamplighter Cir
Villa Park, CA 92861-4528
Phone (714) 944-3983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1003504598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18392 OLD LAMPLIGHTER CIR",
            "city": "VILLA PARK",
            "state": "CA",
            "postal_code": "928614528",
            "telephone_number": "714-944-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3848 N MCKINLEY ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928796569",
            "telephone_number": "951-371-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18392 Old Lamplighter Cir",
            "address_purpose": "LOCATION",
            "city": "Villa Park",
            "state": "CA",
            "postal_code": "928614528",
            "country_code": "US",
            "telephone_number": "714-944-3983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KABBARA",
        "first_name": "ALIA",
        "middle_name": "MEAGAN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-10-25",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.